The report pulls together new financial modelling, public perceptions work and policy analysis to identify the current problems with adult social care in England and the costs of alternative models

It highlights low public awareness of social care and a lack of agreement on priorities for reform as major barriers to progress, despite political consensus on the need for urgent action.

It concludes that reforming the current system will be expensive, but if reform is chosen, England is now at a clear ‘fork in the road’ with a choice between a better means-tested system and one that is more like the NHS; free at the point of use for those who need it.

Key findings:

Maintaining the current system, which sees fewer people receiving publicly-funded care every year, will lead to a funding gap of £6bn by 2030/31.

Returning access to pre-austerity (2009/10) levels would increase this gap to £15bn. More fundamental reforms, whilst still expensive, would cost less than that and would offer the chance of a fairer and less complex system, providing support to more people.

Implementing a 'cap and floor’ model similar to the Conservative Party proposal at the 2017 general election would cost an extra £12bn, whilst introducing free personal care for all older people with needs above the current threshold would increase the funding gap to £14bn.

Public perceptions findings from the National Centre for Social Research’s British Social Attitudes survey reveal extremely low understanding of how social care operates, with 34% believing the government pays. When asked who should fund social care, 41% felt it should be entirely tax-funded.

With taxation the most likely option for boosting social care funding, the findings of separate deliberative work carried out by Ipsos Mori show most people would prefer a dedicated tax to stop the money being diverted elsewhere. Options that include the possibility of people selling their homes to cover care costs, as exists now, were found to be deeply unpopular.